Alternate Investment Access

*Name

*Address

*City *State AK AL AZ AR CA CO CT DE FL GA HI IA IL IN IA KS KY LA MA MD ME MI MS MO MN MT NE NY NV NH NJ NM NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY [select state]

*Zip Code/ Mail Code

*Country

*Phone #

*Email

*Fax #

If the interested party represents a business, trust, or other corporate entity, please provide the following additional contact information.

Entity Name

Contact Title

*I am a/an (check one below):

Individual Investor

Family Office

Planner/Advisor/Broker

Consultant

Fund of Funds Manager

I am or represent (check where appropriate):

*(a) The undersigned hereby certifies that the undersigned is a "qualified client" within the meaning of the Ohio Blue Sky Regulations because the undersigned:

(i) has an individual net worth, or the undersigned and the undersigned's spouse have a combined net worth, in excess of $1,500,000; and/or

(ii) intends to invest at least $750,000 in the Partnership.

(b) The undersigned hereby certifies that the undersigned is an accredited investor because the undersigned has an individual net worth, or the undersigned and the undersigned's spouse have a combined net worth, in excess of $1,000,000.

(c) The undersigned hereby certifies that the undersigned is an accredited investor because the undersigned had individual income (exclusive of any income attributable to the undersigned's spouse) of more than $200,000 in the prior two calendar years or joint income with the undersigned's spouse in excess of $300,000 for each of those years and the undersigned reasonably expects to reach the same income level in the current calendar year.

(d) The undersigned hereby certifies that it is an accredited investor because it is a bank as defined in Section 3(a)(2) of the Act.

(e) The undersigned hereby certifies that it is an accredited investor because it is a savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Act, whether acting in its individual or fiduciary capacity.

(f) The undersigned hereby certifies that it is an accredited investor because it is a broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as amended.

(g) The undersigned hereby certifies that it is an accredited investor because it is an insurance company as defined in Section 2(13) of the Act.

(h) The undersigned hereby certifies that it is an accredited investor because it is an investment company registered under the Investment Company Act of 1940, as amended, or a business development company as defined in Section 2(a)(48) of the Act.

(i) The undersigned hereby certifies that it is an accredited investor because it is a small business investment company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958.

(j) The undersigned hereby certifies that it is an accredited investor because it is a private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended.

(k) The undersigned hereby certifies that it is an accredited investor because it is a corporation, partnership, an organization described in Section 501(c)(3) of the Internal Revenue Code of 1986, or a Massachusetts or similar business trust, not formed for the specific purpose of acquiring the Partnership Interests, with total assets in excess of $5,000,000.

(l) The undersigned hereby certifies that it is an accredited investor because it is a trust, with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the Partnership Interests, whose purchase of the Partnership Interests is directed by a sophisticated person as described in Rule 506(b)(ii) of Regulation D promulgated under the Act.

(m) The undersigned hereby certifies that it is an accredited investor because it is an entity in which all of the equity owners meet one of the requirements of subsections (i) through (xi) hereof.

(n) The undersigned certifies that the undersigned is a director or executive officer of the General Partner.

*GENERAL INVESTMENT OBJECTIVES:

Aggressive Growth Moderate Growth Conservative Growth

*Primary objective of this investment is

*Time willing to keep funds invested to achieve objective is (check one):

*Please indicate any additional information you think we should know regarding your investment objectives, risk tolerance, and financial needs

*INVESTMENT EXPERIENCE:

None Limited Moderate Extensive

*I invest in stocks and/or mutual funds for myself: Yes No

*Total amount invested in the stock market $

*Total number of Investment Advisors I employ

*Number of investment advisors I replaced in the last 4 years

*Reason for replacement

I check my investment values:

yearly quarterly monthly weekly daily

The undersigned hereby certifies that the undersigned has such knowledge and experience in financial and business matters that the undersigned is capable of evaluating the merits and risks of an investment in the Partnership Interests.